Approximately 15% of adults in the United States have chronic kidney disease (CKD). Aging is associated with a decline in kidney function, as estimated by glomerular filtration rate (GFR), even in healthy individuals without CKD. Furthermore, declining kidney function with age occurs faster in people who smoke or have obesity, diabetes, or high blood pressure. Lower GFR is associated with complications, such as heart disease and stroke, kidney failure, and early death.3 Thus, health care providers should pay special attention to a lower GFR when giving medicines (i.e., dosing) that are filtered through the kidneys to older individuals and CKD patients.
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Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020
Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). However, medical care delay or avoidance might increase morbidity and mortality risk associated with treatable and preventable health conditions and might contribute to reported excess deaths directly or indirectly related to COVID-19.
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Are You Aware: Quick Facts About Kidney Disease
In the United States, it is estimated that about 37 million adults have chronic kidney disease (CKD).1 Generally, sleep problems have been associated with higher mortality risk, chronic diseases such as heart disease, and progression of CKD.2-4 As a considerable proportion of the US population has reported sleep problems, prevalence is generally higher in adults with CKD than adults without CKD.3
In the 2013-2014 National Health and Nutrition Examination Survey, two in five (41.0%) adults with CKD stages 3 and 4 reported trouble sleeping compared with 29.2% in adults with CKD stages 1 and 2* and 27.1% in adults with no CKD. The percentage reporting sleep disorders was also higher in adults with CKD stages 3 and 4 (17.7%) and CKD stages 1 and 2 (13.6%) than in adults without CKD (9.6%). Nocturia (waking up during the night to urinate) was also more prevalent in adults with CKD—39.4% in CKD stages 3 and 4 and 38.7% in CKD stages 1 and 2—compared with 24.3% in adults with no CKD. On the other hand, inadequate sleep was similar among adults with and without CKD.
The higher burden of sleep problems among adults with CKD, especially with stages 3 and 4, highlights the importance for early detection and management of these symptoms in the primary and specialty care settings.
References:
1. Centers for Disease Control and Prevention. Chronic Kidney Disease Basics website. https://www.cdc.gov/kidneydisease/basics.html.
2. Centers for Disease Control and Prevention. Sleep and Sleep Disorders website. https://www.cdc.gov/sleep/index.html.
3. Shieu M, Morgenstern H, Bragg-Gresham J, et al. US trends in prevalence of sleep problems and associations with chronic kidney disease and mortality. Kidney360. 2020;1(6):458–468. DOI: https://doi.org/10.34067/KID.0000862019.
4. Molnar MZ, Mucsi I, Novak M, et al. Association of incident obstructive sleep apnea with outcomes in a large cohort of US veterans. Thorax. 2015;70(9):888–895. DOI: 10.1136/thoraxjnl-2015-206970.
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